Laser eye surgery's custom corneas...
Laser eye surgery has become the third most popular surgical treatment in Britain. An estimated 100,000 people undergo the procedure each year, around 20 million worldwide. But now, not only can patients fix their eyesight, they can have their corneas tailored to meet specific visual demands.
For example, Julian Stevens, an expert on laser refractive surgery at the Moorfields Eye Hospital has, in the past, performed tailored treatment for members of the special forces who, “require 1,000-meter vision at night…..It is the same for fighter pilots.”
But the custom cornea reshaping doesn’t stop there, Stevens increasingly performs the surgery to cope the more mundane work/life demands of office workers and long-distance lorry drivers.
The refractive power of a lens is measured in diopters. “Vision changes by about 0.3 diopters at night,” he said. “If you are a sniper that’s critical. It is also important for long-distance lorry drivers, who need excellent night-time distance vision.”
Professor Stephen Trokel, the first to demonstrate the application of the excimer laser (then used for carving microchips) to the field of eye surgery in 1983, recently operated on a leading soprano in his New York clinic.
She had requested her eyesight be corrected so she could see the front row of the orchestra and read the music:
“I also had a catcher for the New York Yankees whose vision was terrible and who needed to be able to see a ball coming out of the light at night,” Trokel added.
Laser refractive surgery corrects vision by altering the shape of the cornea. This technique can be used to treat both myopia (short-sightedness) and hyperopia (longsightedness), but recent technological advancements have made more specific alterations possible,
Wavefront technology, originally developed by Nasa to aid the focus of the Hubble Space Telescope on distant stars, measures up to 250 spots in the pupil to provide a precise map of the cornea and iris. Using this technology doctors can correct problems unresolved by glasses, such as halos around lights or glare.
While it may seem strange to some patients do not necessarily want 20:20 vision, Professor Trokel’s explains that perfect vision is defined by the person’s needs and age.
The eye’s ability to focus on close objects declines with age, and older patients given laser eye surgery to correct myopia, for example, may find that they require reading glasses, simply swapping one set for another.
To compensate, it may become common practice for office workers over 40 seeking eye correction to be made mildly short-sighted.
Public speakers may require monovision – one eye designed for distance vision, the other for reading. Professor Marguerite McDonald, who performed the world’s first excimer laser treatment in New Orleans in 1987, said she had received several requests from US presidential candidates:
“They never wanted to look helpless on the campaign trail because they couldn’t read their notes. They wanted to send a message that they were young.”
With new technologies now offering custom-made corneas, a radical change of lifestyle or career may soon lead to the decision to have one’s eyeballs resculpted. Mr Stevens offers an example:
“One of my patients led an active life and had high-quality distance vision. When he became paralyzed from the neck down, his world became smaller reading and television. Spectacles on your nose become painful if you can’t shift them.”
The solution? Mr Stevens made him slightly short-sighted.
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